Smart Devices for Monitoring of Functional Status in Glioma Patients: A Feasibility Study

Introduction: Monitoring day-to-day functional status in glioma patients may reveal early indicators of clinical deterioration, possibly preceding radiologic changes. This study aimed to establish the feasibility of using smart devices in this population and establish basic trends in physical activity following craniotomy and medical treatment.

Methods: Post-craniotomy patients at our neuro-oncology clinic who received radiation and chemotherapy (RT+chemo) following Stupp protocol were screened and enrolled if they had compatible Apple smartphones and/or smartwatches. Longitudinal health data starting 100 days pre-craniotomy was collected, capturing daily step count, walking speed, basal/active caloric expenditure, walking/running distance, heart rate, and standing time. Data was divided into pre-craniotomy (pre-crani), post-craniotomy/pre-RT+chemo (post-crani), and during RT+chemo (intra-RT+chemo) periods. A linear mixed-effects model tested if biometrics differed significantly in the post-craniotomy and intra-RT+chemo periods compared to pre-craniotomy.

Results: 51 patients were screened of which 23 were enrolled (37.7%). Reasons for exclusion included no-show (n=2/51, 3.9%), incompatible device (n=18/51, 35.3%), and patient declined (n=8/51, 15.7%). 3 patients were excluded after enrollment for insufficient biometric data, leaving a final cohort of 20 patients. 9 patients had smartwatches (45%) and 11 had smartphones only (55%). Age did not differ significantly between smartwatch and smartphone-only users (47.8 vs. 57.7 years, p=0.214).

Compared to pre-craniotomy, patients in the post-crani period showed significantly lower step counts (-1648 steps*), walking speed (-0.133 mph*), basal/active caloric expenditure (-141.6* and -105.7* Calories, respectively), walking/running distance (-0.821 miles*), and standing time (-34.5 minutes*) (p < 0.001*), though heart rate was not significantly different (-0.374 bpm, p=0.538).

Trends were similar, but less pronounced, for the intra-RT+chemo period compared to pre-craniotomy: step count (-376 steps, p=0.001), walking speed (-0.079 mph*), basal/active caloric expenditure (-94.6* and -51.5* Calories, respectively), walking/running distance (-0.264 miles*) (p < 0.001*), standing time (-12.0 minutes, p=0.002), and heart rate (+0.091 bpm, p=0.854).

Conclusion : Physical activity declines were more pronounced post-craniotomy, with partial recovery observed during RT+chemo. Tracking physical activity via smart devices is feasible in glioma patients.